Responding to SARS

By JANE GORDON

Published: April 13, 2003

MARK SOUTRA, a social sciences teacher at East Windsor High School, had been anticipating for months his work-related trip to Guangdong province in southern China at the end of March. The war in Iraq didn't faze him, but when Severe Acute Respiratory Syndrome struck Guangdong province, making it the epicenter of a disease that continues to spread throughout the world, he decided to stay home.

There are at least four suspected cases reported in the state, including one at the University of Connecticut that has state health officials keeping their eyes on the whole campus. Officials would not provide information on the other cases, but Norwalk and Yale-New Haven hospitals said they had treated two people who may have SARS. Some schools are sending notes home to parents explaining the symptoms of SARS and asking students who have traveled to Asia to stay home through the incubation period, about 10 days. Companies are asking workers who have traveled to affected areas to stay home and are also asking employees to cancel some business trips.

The syndrome has killed more than 100 people and infected more than 2,600 worldwide. Fear of SARS has become so pervasive that an American Airlines flight from Tokyo was quarantined at San Jose International Airport on April 1 after five passengers complained of flu-like symptoms similar to SARS.

''There isn't a test for SARS right at the moment,'' said Brenda Grant, a nurse epidemiologist at Stamford Hospital. ''In the meantime, we're just trying to screen anyone coming in with respiratory issues, evaluating them by the symptoms they present, and their travel history or history of their contact with someone who traveled to the Orient.''

The challenge for medical workers is how to distinguish SARS from the flu. The Centers for Disease Control and Prevention in Atlanta has issued its newest definition of SARS as a fever of 100.4 or higher, cough, shortness of breath or difficulty breathing or an abnormal chest X-Ray. Recent travel to Hong Kong, Guangdong Province, Hanoi, Singapore or Toronto within 10 days of the onset of symptoms, or close contact with a person who has been exposed to SARS, also figures in the diagnosis.

Yale-New Haven Hospital doctors recently saw a boarding school student who was sent to the hospital by the school nurse after returning from a trip to Taiwan. He was ill with fever and respiratory symptoms, said Dr. Phil Brewer of Yale-New Haven's emergency department and an assistant professor of medicine at Yale Medical School.

''He would be considered a suspected recovering case, because this is really a diagnosis of exclusion, since we still don't know what the virus is, presuming it is a virus,'' Dr. Brewer said.

There is also no special way to treat SARS.

''There's no specific treatment for SARS, just like there's no specific treatment for the common cold,'' said Dr. Rob Fuller, chairman of emergency department at the University of Connecticut Health Center. ''It's just supportive care. At home, people with SARS are taking anti-fever medicines and eating chicken soup. In the hospital, they'll get IV and respiratory support.''

At the University of Connecticut Health Center, the staff has been monitoring the Web site of the Centers for Disease Control regularly, said Jane Shaskin, spokeswoman for the health center. ''Awareness is heightened,'' she said.

The University of Connecticut undergraduate student suspected of being ill with SARS is a Mansfield resident who was recuperating last week after being admitted to Windham Memorial Community Hospital on March 26. He had returned from an overseas trip, attended classes March 24 and 25, visited the library and attended a poetry reading, potentially exposing others. SARS apparently is spread through the transmission of droplets forced into the air by a cough or a sneeze, although some medical researchers also said they believed it may linger in the air and also be transmitted from objects contaminated with the droplets.

State health and university officials visited the student's classes to explain the symptoms of SARS to other students, and university President Philip Austin sent an e-mail message to the staff, faculty and students alerting them to the possible presence of the virus on campus. So far, no one has been reported ill.

Thirty-eight students and three chaperones from Greenwich Country Day School were already in China when a parent who had planned to meet them there stopped in the Glenville Pharmacy in Greenwich and bought out the shop's entire stock of surgical masks. News that Severe Acute Respiratory Syndrome was spreading had hit Connecticut, and once the parent reached China, the masks were handed out to the entourage. From that day onward, whenever the group boarded a plane inside China, they wore the masks.

Still, when the travelers came home, the school wasn't taking any chances. Doug Lyons, the headmaster, called each family who had a student on the trip and asked them to please stay home for 13 days. One parent, Larry Lawrence, who went on the trip with his son, Ben, 15, said he had no problem with Mr. Lyons's decision.

''After he went through the logic, it seemed pretty wise to me,'' Mr. Lawrence said.

'Mr. Lyons said there is no evidence that anyone in the group had become infected and that his actions were a pre-emptive strike.

''Let's imagine the kids come back to school before the incubation period and one of the kids gets sick with the flu - the conventional flu - and he goes home,'' Mr. Lyons said. ''What's the possible reaction of everyone else in the community? Grave and unnecessary concern. Better they stay home a couple of days and I can manage the anxieties of the rest of the school community.''

Administrators at St. Bridget's Catholic School in Cheshire asked the parents of a preschool student to keep him out of school for 10 days as a precaution. UBS AG, the parent company of UBS Warburg in Stamford and UBS Paine Webber in Harford, issued a note to employees on April 1 prohibiting business travel to Hong Kong, Singapore and China. Toronto and Vietnam were added a few days later. Employees who already had traveled to those locations were asked to stay home for 10 days before returning to work.

Bradley International Airport in Windsor Locks saw no effects on its business from SARS, primarily because it has no direct international flights to Asia. Overseas school field trips are also not being affected by the SARS scare because many schools had already canceled them because of the war in Iraq.

East Windsor has nurtured a teacher exchange program with China for several years, and Mr. Soutra's trip, which he had been planning since late last year, was to have lasted five weeks. He planned to live with a local educator and teach American cultural studies.

''I was supposed to leave the 30th, but I decided to wait,'' Mr. Soutra said. As it turned out, it was the right decision. If I got sick, I would have brought it back to my students, to my family. I'm rescheduled to go Sept. 26. The summer will tell.''

Photos: Amy Margentino, top, a medical assistant at the UConn Health Center, now wears a mask when treating some respiratory patients. Larry Lawrence, above left, with his son, Ben, 15, and, below, a health advisory on SARS at the UConn center. (Photographs by George Ruhe for The New York Times); (Chris Maynard for The New York Times)